PrEP to be publicly subsidised on the PBS in Australia

"There are three new HIV diagnoses each day in Australia and we expect the government will now move quickly to list PrEP on the PBS"

The Pharmaceutical Benefits Advisory Committee (PBAC) has announced its decision to recommend that HIV prevention pill PrEP be listed and subsidised on the Pharmaceutical Benefits Scheme (PBS).

In its decision, the committee noted it was both satisfied with the power of PrEP in reducing the risk of HIV infection, and its cost-effectiveness.

It also emphasised that the drug was appropriate for an eligible population, including medium to high risk individuals.

Advocates and health experts have welcomed the decision, and highlighted it as a critical step towards dramatically reducing HIV transmission in Australia.

PrEP is a once-daily pill with 99 per cent effectiveness at preventing HIV transmission among gay and bisexual men.

It was approved for use in Australia last year by the Therapeutic Goods Administration (TGA), however many were waiting for it to be publicly subsidised and affordable for people around the country.

Chief Executive of the Australian Federation of AIDS Organisations (AFAO), Darryl O’Donnell, said a PBS listing of PrEP was a huge step towards the government’s goal of ending HIV transmission.

“Gay and bisexual men continue to carry the greatest burden of HIV in Australia, and we expect that PrEP will sharply drive down rates of HIV for this community,” he said.

“But great effort will be needed to ensure PrEP access and awareness across all parts of the gay community.

“Additionally, Aboriginal and Torres Strait Islander people, migrant communities, and some heterosexual populations have seen starkly higher rates of HIV transmission over the last five years. While a PBS listing of PrEP is critical, we must make sure everyone who needs PrEP is aware of it and can access it.”

Until now, access to PrEP has been patchy. The full commercial cost sat at almost $5,000 per year, with many Australian PrEP users having to access it via state and territory trials – such as those in Victoria, New South Wales, and Queensland – or online imports.

Subsidisation through the PBS will slash the cost of the medication to around $39 dollars per script for most patients in Australia, and $6.30 for concession cardholders.

President of ACON, Justin Koonin, said the decision was important in ensuring that those who would most benefit from PrEP will be able to access it in an affordable way.

“There are three new HIV diagnoses each day in Australia and we expect the government will now move quickly to list PrEP on the PBS,” he said.

“Prevention of HIV is much cheaper than a lifetime of treatment and it makes good sense to have this medicine available to all who need it.”

Earlier this week, Chief Executive of the Victorian AIDS Council (VAC), Simon Ruth, raised concerns around the capacity of GPs to prescribe PrEP in the event of a PBS listing.

“There are 8,000 people in the NSW [PrEP] trial and 4,000 in the Victorian trial, so there are at least two thousand guys in Melbourne wanting to access PrEP – in the event of it being subsidised, there will be a lot of people seeking GP appointments very quickly,” he said.